Clinical Integration

According to the American Medical Association (AMA), clinical integration is the means to facilitate patient care. This takes place across various conditions, providers, settings, and time so that safe, timely, efficient, effective, and patient-focused care is achieved. Many legal statutes covering clinical integration are included in the 2011 Affordable Care Act (ACA), also known as Obamacare.

Clinical integration is important due to the following factors:

1. Many health care professionals and organizations operate without much connection or communication with one another.
2. Many general practice doctors operate alone, or in small practice groups, and do not always have access to enhanced, such as electronic health records.
3. Without the coordination provided by clinical integration, a patient may receive conflicting information.

Clinical integration seeks to maintain quality and value across health management systems. Many incentives in the health care field have been shifted from the volume of services provided to the quality of services provided. Clinical integration ties together primary care physicians, hospitals, pharmacists, social workers and other clinicians to improve the overall level of patient care. The growth and development of technology, including electronic health records, should facilitate the expansion of clinical integration in the near future.

An example of clinical integration is Kaiser Permentente (KP). KP established many of the key concepts of managed care including capitation, a risk pool, group practice, preventative care, and integrated care. The latter, integrated care, has become a foundational component of success for Kaiser Permanente. Specifically, Strandberg-Larsen, et al. (2010) report that in order to create efficiency in its operations, KP focused on a model of integrated care in which united the financing group in the operation with all providers from hospitals to pharmacies to long-term care clinics. Strandberg-Larsen and coworkers go on to argue that as a result of their efforts, leaders at KP have created as seamless organization in which all providers are viewed as on entity known as Kaiser. Thus, when a patient sees a physician at a primary care clinic, the patient is part of the larger Kaiser system and is able to acquire care through all entities operated by the organization